Exams and Tests

To find out if you have or are at risk for coronary artery disease, your doctor will do a physical exam and check your risk based on your health and risk factors.

You may then have several different kinds of tests to check your risk for getting heart disease. If your doctor thinks you have heart disease, you will need more tests to make sure.

Tests to measure your risk for coronary artery disease

The main tests your doctor uses to check your risk for getting heart disease include:

• Blood pressure. High blood pressure increases your risk for heart disease.
• Cholesterol (a blood test). High cholesterol increases your risk for heart disease.

Your doctor will use your blood pressure, cholesterol, and other risk factors such as your age and if you smoke, to know your risk of heart disease. If you know your blood pressure and cholesterol levels, you can check your risk for a heart attack:

Interactive Tool: Are You at Risk for a Heart Attack?

Other tests may help your doctor find out your risk for heart disease, especially when they are considered along with your other risk factors. But these tests are not helpful for everyone. Such tests may include:

• C-reactive protein (CRP) test. High CRP levels are linked to higher risk for heart disease.
• Coronary calcium scan. This test uses a special kind of X-ray to check for buildup of calcium in the heart's arteries. The result is a number, or score. If you have a high score, you may need more tests to check for heart disease or to find out how bad it is. For more information, see:

  Heart Disease Risk: Should I Have a Coronary Calcium Scan?

Sometimes doctors schedule routine tests because they think that's what patients expect. But experts say routine heart tests can be a waste of time and money. See the topic Heart Tests: When Do You Need Them?

Tests to diagnose coronary artery disease

If your doctor thinks you may have heart disease, you will need some tests to make sure. Most often, the first tests include:

• An electrocardiogram (EKG or ECG).
• A chest X-ray.
• Blood tests.
• An exercise electrocardiogram. This is also called a "stress test."

Other tests may include:

• Cardiac perfusion scan. This test shows if you have enough blood flow to the heart.
• Echocardiogram and stress echocardiogram. This test uses ultrasound to see areas of poor blood flow in the heart. It can also check how well your heart is working after a heart attack. The test can help your doctor find out how much blood your heart is pumping during each heartbeat (ejection fraction).
• Coronary angiogram. This is an X-ray test that creates pictures of the blood flow through your coronary arteries. It allows your doctor to see any blockage or narrowing of the artery. It's done using a soft, thin tube (catheter) that is put in a blood vessel in the arm or groin and gently moved into the heart. For more information, see the topic:

  Heart Disease: Should I Have an Angiogram?

• CT angiogram. CT (computed tomography) angiograms use X-rays to get detailed pictures of the heart and its blood vessels.